Pharmacist’s Firing Raises Ethics, Safety, and Policy Questions

Jim Ruble, PharmD, JD;Sujeta,Kayla;

Key Takeaways

A pharmacist supervisor was terminated for disclosing staffing issues, raising concerns about patient safety and burnout due to understaffing.
The plaintiff's LinkedIn comments on staffing challenges led to termination for policy violations, sparking a lawsuit for wrongful discharge.
Defendants seek dismissal, citing exemptions for professional services, highlighting the conflict between ethical and legal obligations.
The case underscores the complexity of balancing pharmacist commitments to patient safety with employer policies and proprietary information.

A pharmacist's termination raises critical questions about staffing policies, patient safety, and ethical obligations in healthcare. Explore the ongoing legal battle.

In May 2024, a pharmacist supervisor in North Carolina was terminated for disclosing allegedly confidential information regarding staffing practices by her employer (a hospital) and its parent health care system. The pharmacist supervised a pharmacy team who provided transitions of care and medication reconciliation services. According to the complaint, over the course of 2 years, the plaintiff’s team was understaffed for an extended time, operating at a 60% staffing level in part due to staff turnover and also due to a hiring freeze implemented by the employer. The plaintiff expressed concerns regarding staffing challenges, including dangers to patient safety. It was further alleged that team members were experiencing burnout due to low staffing levels, preventing patients from receiving the full attention required to ensure patient safety. The complaint states that the health system did not address these concerns.

Image Credit: Rose | stock.adobe.com

About the Authors

Jim Ruble, PharmD, JD, is executive associate dean and professor in the University of Utah College of Pharmacy in Salt Lake City.

Kayla Sujeta is a second-year PharmD student at the University of Utah College of Pharmacy in Salt Lake City.

The plaintiff reviewed information posted by a third party on LinkedIn regarding staffing level practices and financial performance at the hospital and health system and subsequently commented on this third-party information, adding her observations:

“The [full-time equivalent] battle is real here. From my understanding, staffing is determined by [average patient] days times a multiplier. The multiplier here is lower than other [defendant] facilities. We are constantly ‘in the red’ despite having as many as 90 open shifts not covered last schedule period … Haven’t been able to get answers there. Positions on my team have been ‘frozen’ for months; we are 60% staffed. Understandably, due to staffing, [medication] histories are not accurately or routinely obtained by nursing.”

About 8 days after posting this on LinkedIn, the plaintiff received a termination notice from the hospital. The notice said the plaintiff was being terminated due to “conduct/behavior” and “policy violation,” and the plaintiff ’s supervisor further said that information regarding the hospital and health system’s staffing ratios is proprietary, and questioning the policy regarding patient safety and burnout goes against the conduct and behavior policy for employees. The case is ongoing.

The Legal Process and Questions Presented

The plaintiff filed a lawsuit alleging wrongful discharge against public policies described in the North Carolina administrative code and violation of the North Carolina Unfair and Deceptive Trade Practices Act (UDTPA) by the defendants.

The defendants have filed motions to dismiss the plaintiff ’s complaint based on failure of actionable claims. The defendants cite they are exempt from the UDTPA in North Carolina because professional services rendered by a member of a “learned profession” (ie, a profession that requires advanced knowledge) are expressly excluded from statutory protection. This case presents questions on the scope and balance of pharmacist commitments to their patients and to their employer. As described in the complaint, North Carolina regulations incorporate the American Pharmacists Association Code of Ethics, which says pharmacists should place patient well-being and safety at the center of professional practice. This is an important reminder of the complexity of decisions involving aspirational (ethical) guidance and mandatory (legal) obligations, and whether alleged public policy or alleged proprietary information takes priority.